ATI RN
ATI Pediatric Proctored Exam 2023
1. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
- A. Massive proteinuria, hypoalbuminemia, and edema
- B. Hematuria, bacteriuria, and weight gain
- C. Decreased urine specific gravity and increased urinary output
- D. Gross hematuria, albuminuria, and fever
Correct answer: A
Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.
2. How does an occupational therapist use clinical guidelines to inform practice with children and youth?
- A. Modify guidelines to fit the specific environment
- B. Establish systems to monitor outcomes
- C. Select the most recent guidelines without considering the client
- D. Consider guidelines that fit one's clientele and environment
Correct answer: C
Rationale: When using clinical guidelines to inform practice with children and youth, it is crucial for occupational therapists to not solely rely on the most recent guidelines but to consider the individual needs and contexts of each client. Selecting guidelines based solely on recency without considering the specific client can lead to ineffective or inappropriate interventions.
3. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?
- A. Compensating
- B. Adapting
- C. Grading
- D. Modifying
Correct answer: C
Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.
4. Which is the appropriate intervention when providing care to a child diagnosed with nephrotic syndrome, who is edematous and on bed rest?
- A. Monitor blood pressure every 30 minutes.
- B. Reposition every 2 hours.
- C. Limit visitors.
- D. Encourage fluids.
Correct answer: B
Rationale: Repositioning every 2 hours is crucial in preventing skin breakdown in an edematous child on bed rest. This intervention helps redistribute pressure and maintain skin integrity, reducing the risk of pressure ulcers. It is an essential part of care for patients with limited mobility to ensure their comfort and prevent complications related to immobility.
5. Which standardized test would be most appropriate for assessing the motor development of a 2-month-old infant in a high-risk clinic?
- A. Peabody Developmental Motor Scale (PDMS-2)
- B. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
- C. Pediatric Evaluation of Disability Index (PEDI)
- D. School Assessment of Motor and Process Skills (School-AMPS)
Correct answer: A
Rationale: The Peabody Developmental Motor Scale (PDMS-2) is specifically designed to assess the motor development of infants and young children, making it the most appropriate choice for evaluating a 2-month-old infant in a high-risk clinic setting.
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